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This is somewhat of an ode to my uncle, and some introspection as to why I do the things I do, and why I fight hard for others.

My uncle suffered with schizophrenia. My uncle also only had a green card for a while and when he finally became a citizen, he was unable to work because he would make “too much” and he would not qualify for state benefits to pay for his medications. Without medications he could not work, he died at age 40 from a heart attack and lived at home with his parents his entire life.

This man was not a stupid man; he had a thirst for knowledge and a drive to do so many things with his life. He always struck me as a researcher; he was constantly recording documentaries, collecting books, cataloguing information about any and everything! He moved to this country and he knew he would not be able to achieve his lifelong dreams, he was 18, and at 19 he started displaying psychotic symptoms.

He was never able to move out of his parents’ home, unable to work, unable to study. He had very few things in life to be happy about. He had little to look forward to, all because with a job he could not qualify to receive his medications. He was unable to contribute because he had mental illness, and unlike diabetes or asthma his condition was not and still is not considered okay in American Culture.

If mental Illness were classified the same way physical health ailments are, he may have had a chance. No American would tell a diabetic they could not have an insulin shot if they got a job, or look down on the person struggling because they blood sugar lowered. These are not response we are willing to make, because a medical doctor told the nation it was a medical problem.

I got into this practice because I wanted to fight for people like my uncle. I’ve come across several families struggling with similar issues, it is always the same, because of the stigma and the fact that he was not “from here” there are few sympathetic ears. I find myself in a clinical role but I want to advocate. It is a fine line, advocating for the client while maintaining good therapeutic distance because in therapy, without major changes to the system- what can be said?

The Depression is often situational

The PTSD is because life has been hard, and in some cases outside of the normal mainstream culture

The Anxiety is due to not knowing what will happen next for you, your family and/or community.

I have been working on a project for one of my classes, in my project I have been interviewing Hispanic immigrants in North Carolina and while I was transcribing the interview I connected with something my informant told me. He spoke about the value of numbers- particularly the numbers assigned to a person via social security. Growing up those 9 numbers dictated his life, he was ruled by the power of that 9 number sequence- It got me thinking about the numbers we assign people in any system we belong to, take for example the mental health system. In mental health before a client is seen we request their social security number, date of birth, age, insurance number, we call up the management entity to gather information about their record number. Before anyone even talks to this person they become a mathematical code.

The equation continues to complicate as the individual returns their paperwork to the receptionist and the individual waits for their appointment time. The clinician steps out of their office after being informed that their 9:00am appointment as arrived. The clinician starts to build the relationship and starts the assessment process, typically with a standardized form to assess for an array of typical symptoms, many of the symptoms searching for frequency and duration.

More numbers.

The assessment concludes and the clinician sits with the information that was gathered in the assessment; notes about the duration and frequency of the symptoms, notes about stressors and what brought them to the office for the assessment, Notes about their hopes and dreams for a future without this stressor. Upon reviewing these notes it is time for the clinician to think about the final numbers this person will receive in order to see this person, and bill insurance for the service.

The problem has been calculated down- now it is time for the clinician to justify the final numbers the client will receive, will it be 309.0 Adjustment with Depressed mood, or is it in fact 311 Depressive Disorder not otherwise specified, should the clinician rule out another number and later give them their GAF, or Global Assessment of Functioning number that is in the 50s range or the 60s.

It is my fear that after a while, with soaring caseloads and the current state of mental health in the nation. It is easy to see where a person would stop existing as a person and is instead the person becomes that number, that diagnosis, that social security number. It is my hope that people will stop being numbers and get back to being a more human and compassionate world. There seems to be no time to spend that time anymore, but that time is what fosters growth and allows for personal introspection.